Indian Firm Develops Inexpensive Vaccine for Battle With Cholera

A suspected cholera patient at a hospital in the eastern village of Tikiri, Orissa, during a 2007 outbreak of cholera in the state.

Agence France-Presse/Getty Images

Hilleman Laboratories Pvt., an Indian biotechnology non-profit, says it has developed an affordable and rugged cholera vaccine which could change how the battle with deadly disease is fought.

New Delhi-based Hilleman Laboratories Pvt. — which is backed by Merck & Co. and the Wellcome Trust charity — said Tuesday that it has created an inexpensive vaccine that can survive without refrigeration in the far-flung tropical villages where it is most needed.

Cholera kills over a hundred thousand people, mostly young children, and infects millions every year.

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“Cholera is a huge public health burden,” said Hilleman Chief Executive Davinder Gill. “The disease is endemic in over 50 countries across the world but it especially huge in the subcontinent and especially in the Bengal delta.”

The vaccine is a dry power, capable of surviving temperatures of 45 degrees Celsius and is produced in a way which dramatically reduces the cost of manufacturing. One dose of the vaccine should eventually cost “significantly less than one U.S. dollar,” Mr. Gill said. He hopes to start clinical trials next year.

Cholera infections are caused by drinking water infected with the bacteria. If left untreated, cholera bacteria cause severe diarrhea, dehydration and sometimes death. Diarrhea kills 800,000 children under the age of five every year, according to Unicef. A quarter of those deaths are in India.

While there are already other vaccines to ward off the bacterial infection, they are often in short supply and poorly suited for use in impoverished areas of the world where the disease is most prevalent.

The two vaccines used today, Dukoral and Shanchol, are not widely enough used to be effective in helping eradicate the disease.

Dukoral is too expensive for most poor countries, costing between $4 and $9 per dose, according to data from the World Health Organization. It is complicated to deliver, requiring a large amount of water, a problem in cholera-stricken areas with limited access to clean water. The vaccine also has to be refrigerated or it ceases to be effective after a few weeks in storage.

Shanchol costs around $1.85 a dose, according to WHO data, but it also requires refrigeration.

The need for a cold storage chain makes these vaccines less than ideal to fight cholera outbreaks, which usually follow natural disasters like the 2010 earthquake in Haiti. Because of the prices and need for refrigeration, demand for the vaccines has been limited considering the global size of the problem.

“All of us in public health said we needed a cholera vaccine, but until (the companies) actually see the orders it was kind of a vicious circle of low demand leading to low supply,” said David Sack, a professor at Johns Hopkins Bloomberg School of Public Health who has been studying how to fight cholera since 1975.

The maker of Shanchol, pharmaceutical giant Sanofi SA, said that while it is working on creating a dedicated manufacturing facility for its vaccine, the demand from cholera-affected countries remains limited.

To have a chance at eradicating cholera, the world needs around 100 million doses of a cholera vaccine at around 50 cents a dose, said Dr. Sack.

“Now, we have three million doses at the cost of $1.85 per dose — and currently we need two doses,” he said. “It’s a problem.”

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